Pyelonephritis

Definition

Most common upper UTI

Acute inflammation of the kidney

Advanced pyelonephritis involves the tubules which become necrotic

Large amounts of white blood cells accumulate in the tubules

Physical exam findings

Yellow and hazy, possibly cloudy or turbid

Clinical presentation

Sudden onset

dysuria

Nocturne

Flank pain

fever symptoms

Elderly patients have mental distress

Chemical exam findings

Small protein

Positive leukocyte esterase

Positive nitrite

Small blood

Normal to low specific gravity

Microscopic exam findings

WBC

Bacteria

RBC

RTE

WBC casts

Granular, RTE, or waxy casts